Why Alzheimer’s Will Be The Fiscal Nightmare Of The Century

A new study by the RAND
Corporation projects that the cumulative costs of caring
for people with dementia could be as high as $215 billion
annually in the United States – which would exceed the combined
costs of heart disease and cancer.

RAND’s research is the latest addition to the growing body of
evidence that shows Alzheimer’s is poised to become the
fiscal nightmare of the 21st century. Perhaps most notably,
their work confirms the World Health Organization’s bold claim a year ago that
Alzheimer’s was a “public health priority.” The WHO, to be
sure, doesn’t use this language lightly.

The RAND study also validates the U.S.’s recent launch of its
“national
plan” to defeat Alzheimer’s. It adds some much-needed vigor
to the debate about just how much Alzheimer’s will cost. RAND’s
estimates are lower than those of the Alzheimer’s
Association, but both organizations agree that costs are
shooting straight up.

A debate, of course, about the expenses of Alzheimer’s is
welcome. Disagreement will attract attention, since for far too
long Alzheimer’s has been relegated to the “back burner.”

But here’s the dirty little secret prompted by the RAND study:
Alzheimer’s is about the children. They’ll be the ones who will
have to pay for older Americans. It will no longer be possible,
ethics aside, to hide behind the cliché, “Oh, well, they’re just
getting old and…”

Why? The numbers will be too overwhelming. What the RAND study
teaches more than anything is that we must de-link aging and Alzheimer’s.

For decades, our budget debates have often pitted “guns” against
“butter.” But if we allow Alzheimer’s to continue to be
considered a natural, inevitable part of the aging process, it is
going to consume so much national and global spending that before
long, budget battles will pit “butter” against “butter.” At
upwards of $56,000 of spending per year per dementia patient –
and with Americans having a 1-in-8 chance of getting dementia
after the age of 65 (and a 1 in 2.5 chance after the age of 85) –
the fiscal balance sheets of the future will be consumed by
Alzheimer’s caregiving costs.

So what can we do about dementia so that it doesn’t become the
kids’ burden?

Here are two things, for starters:

Number
1:
We need to do for dementia what we did for HIV/AIDS. The great
lesson from the HIV/AIDS outbreak is that moral outrage,
political pressure, and self-interest can spur research and
development efforts. In just two decades, HIV/AIDS
was transformed from a definite death sentence to a manageable
condition.

Although Alzheimer’s has a number of notoriously difficult
hurdles to clear de-stigmatizing early diagnosis, greater
understanding even of its basic science  HIV/AIDs sets the model
for success. It’s critical we recognize that Alzheimer’s is not a
natural part of aging, and we ought to be outraged that we’re not
doing more to combat it. Then we can begin to mount the political
pressure to generate more funding to find better therapies.

Number
2: We should engage in an
intense global conversation about dementia that could lead to
creation of a Global Fund, not unlike the Global Community did
for HIV/AIDs. The RAND study converges with other activity to
spark this.

President Obama recently pledged $100 million to the
BRAIN Initiative to support technologies to map the
brain. Across the pond, even in its beleaguered financial
state, the Dutch government is leading Europe as it
will announce a roughly $260 million investment in
research and care improvements – because it will save that
government about $3.9 billion in future costs.

In June, the OECD will host an “expert consultation” aimed at
“unlocking global collaboration to accelerate innovation for
Alzheimer’s disease and dementia” in conjunction with the Global
Coalition on Aging and Harris Manchester College at Oxford
University. The driver there will be how to use “big data” to solve Alzheimer’s.

On top of that, at this year’s Milken Conference in Los Angeles,
a session on Alzheimer’s has been scheduled by the newly formed
CEO Initiative, an organization of private-sector leaders who
have joined together to provide business leadership on the fight
against Alzheimer’s.

Over the generations, Rand has been an intellectual catalyst for
big social and economic changes, on topics from the environment
to nuclear arms control. This could be the biggest of them all –
not least for the children who will benefit from the paradigm
shift in which we no longer complacently accept that aging is to
be automatically associated with the crushing torture of
Alzheimer’s.

Michael W. Hodin, Ph.D., is executive director of
the Global Coalition on Aging and managing partner
of the High Lantern Group.